Rascol O, Sabatini U, Fabre N, Senard J M, Simonetta-Moreau M, Montastruc J L, Clanet M, Rascol A
Laboratory of Medical and Clinical Pharmacology (INSERM U 317), University Hospital of Toulouse, France.
Mov Disord. 1995 Mar;10(2):163-70. doi: 10.1002/mds.870100206.
We have measured the gain of the vestibuloocular reflex (VOR) in darkness and its cancellation by fixation in 37 patients with Parkinson's disease (PD), 26 patients with multiple system atrophy (MSA), 11 patients with progressive supranuclear palsy (PSP), and 19 normal volunteers. The capacity to cancel the VOR by fixation (VOR cancellation) was significantly reduced in the MSA and PSP patients compared with the PD and normal subjects (p < 10(-4)). A VOR cancellation < 90% (i.e., the mean VOR cancellation of the normals--2 SD) was present in four PD patients, 23 MSA patients, and 11 PSP patients. This criteria distinguished PD and MSA with a 89% sensitivity and a 89% specificity. Our results demonstrate that the VOR cancellation is impaired in most patients with MSA and PSP but not with PD. In MSA patients, the abnormal VOR cancellation is probably not related to the nigrostriatal dopaminergic deficit and more likely reflects a cerebellar dysfunction. Impaired VOR cancellation is a clinical criteria to differentiate MSA and PSP from PD.
我们测量了37例帕金森病（PD）患者、26例多系统萎缩（MSA）患者、11例进行性核上性麻痹（PSP）患者以及19名正常志愿者在黑暗中的前庭眼反射（VOR）增益及其通过注视消除的情况。与PD患者和正常受试者相比，MSA和PSP患者通过注视消除VOR的能力（VOR消除）显著降低（p < 10(-4)）。4例PD患者、23例MSA患者和11例PSP患者存在VOR消除< 90%（即正常受试者的平均VOR消除-2个标准差）。该标准区分PD和MSA的敏感性为89%，特异性为89%。我们的结果表明，大多数MSA和PSP患者的VOR消除受损，而PD患者则未受损。在MSA患者中，异常的VOR消除可能与黑质纹状体多巴胺能缺陷无关，更可能反映小脑功能障碍。VOR消除受损是区分MSA和PSP与PD的临床标准。
